Minim Invas Neurosur
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Minim Invas Neurosur · Dec 2008
Accuracy and clinical use of a novel aiming device for frameless stereotactic brain biopsy.
Aiming devices enable the use of neuronavigation systems for rigid instrument guidance mimicking the possibilities of a frame-based system without having a stereotactic frame affixed to the skull. The aim of the presented work was to investigate the phantom targeting accuracy of the Vertek aiming device (Medtronic Inc., Louisville, USA) and whether it can be safely and accurately applied in a concept of minimally invasive brain biopsy in which multi-modal image fusion, image-to-patient registration and head immobilization were based on a non-invasive vacuum mouthpiece. A plastic model of a head with 20 target beads broadly distributed around the head volume was used for determination of CT-based targeting accuracy. ⋯ The experimental results showed a similar accuracy to frame-based stereotaxy. The device facilitates trajectory alignment via two pivot joints and the actual depth and location of the biopsy needle can be monitored. Within the limitations of a preliminary study, brain biopsy may be accurately and safely performed for lesions > or = 12 mm.
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Minim Invas Neurosur · Dec 2008
Case ReportsCombined treatment of ruptured aneurysm accompanied by intraventricular hemorrhage; neuroendoscopy and coiling: case report.
Subarachnoid hemorrhages with intraventricular hemorrhage (IVH) have been treated with aneurysmal clipping and ventricular drainage. We present a combined treatment with coiling and endoscopy: coiling of the ruptured distal anterior cerebral artery aneurysm and neuroendoscopic removal of IVH.
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Minim Invas Neurosur · Dec 2008
Case ReportsEndoscopic endonasal management of petroclival cerebrospinal fluid leaks: anatomical study and preliminary clinical experience.
Endonasal management of most anterior cranial fossa cerebrospinal fluid leaks is a well established procedure, and even some middle cranial fossa cerebrospinal fluid leaks can be managed safely endonasally. Endonasal endoscopic management of leakages of the posterior cranial fossa represents an unique challenge. ⋯ Endonasal endoscopic management of well-selected petroclival cerebrospinal fluid leaks is feasible.